VOCATIONAL REHABILITATION DEMONSTRATION PROJECTS.

SEC. 5120. VOCATIONAL REHABILITATION DEMONSTRATION PROJECTS. (a) Demonstration Project.— (1) In general.—Pursuant to section 505 of the Social Security Disability Amendments of 1980, the Secretary of Health and Human Services shall develop and carry out under this section demonstration projects in each of not fewer than three States. Each such demonstration project shall be designed to assess the advantages and disadvantages of permitting disabled beneficiaries (as defined in paragraph (3)) to select, from among both public and private qualified vocational rehabilitation providers, providers of vocational rehabilitation services directed at enabling such beneficiaries to engage in substantial gainful activity. Each such demonstration project shall commence as soon as practicable after the date of the enactment of this Act and shall remain in operation until the end of fiscal year 1993. (2) Scope and participation.—Each demonstration project shall be of sufficient scope and open to sufficient participation by disabled beneficiaries so as to permit meaningful determinations under subsection (b). (3) Disabled beneficiary.—For purposes of this section, the term “disabled beneficiary” means an individual who is entitled to disability insurance benefits under section 223 of the Social 104 STAT. 1388–281Security Act or benefits under section 202 of such Act based on such individual’s own disability. (b) Matters to Be Determined.—In the course of each demonstration project conducted under this section, the Secretary shall determine the following: (1) the extent to which disabled beneficiaries participate in the process of selecting providers of rehabilitation services, and their reasons for participating or not participating; (2) notable characteristics of participating disabled beneficiaries (including their impairments), classified by the type of provider selected; (3) the various needs for rehabilitation demonstrated by participating disabled beneficiaries, classified by the type of provider selected; (4) the extent to which providers of rehabilitation services which are not agencies or instrumentalities of States accept referrals of disabled beneficiaries under procedures in effect under section 222(d) of the Social Security Act as of the date of the enactment of this Act relating to reimbursement for such services and the most effective way of reimbursing such providers in accordance with such provisions; (5) the extent to which providers participating in the demonstration projects enter into contracts with third parties for services and the types of such services; (6) whether, and if so the extent to which, disabled beneficiaries who select their own providers of rehabilitation services are more likely to engage in substantial gainful activity and thereby terminate their entitlement under section 202 or 223 of the Social Security Act than those who do not; (7) the cost effectiveness of permitting disabled beneficiaries to select their providers of vocational rehabilitation services, and the comparative cost effectiveness of different types of providers; and (8) the feasibility of establishing a permanent national program for allowing disabled beneficiaries to choose their own qualified vocational rehabilitation provider and any additional safeguards which would be necessary to assure the effectiveness of such a program. (c) Procedural Requirements.— (1) Selection of participants.—The Secretary shall select for participation in each demonstration project under this section disabled beneficiaries for whom there is a reasonable likelihood that rehabilitation services provided to them will result in performance by them of substantial gainful activity for a continuous period of nine months prior to termination of the project. (2) Selection of providers of rehabilitation services.—The Secretary shall select qualified rehabilitation agencies to serve as providers of rehabilitation services in the geographic area covered by each demonstration project conducted under this section. The Secretary shall make such selection after consultation with disabled individuals and organizations representing such individuals. With respect to each demonstration project, the Secretary may approve on a case-by-case basis additional qualified rehabilitation agencies from outside the geographic area covered by the project to serve particular disabled beneficiaries. 104 STAT. 1388–282 (3) Reimbursement of providers.— (A) Except as provided in subparagraph (B), providers of rehabilitation services under each demonstration project under this section shall be reimbursed in accordance with the procedures in effect under the provisions of section 222(d) of the Social Security Act as of the date of the enactment of this Act relating to reimbursement for services provided under such section. (B) The Secretary may contract with providers of rehabilitation services under each demonstration project under this section on a fee-for-service basis in order to—(i) conduct vocational evaluations directed at identifying those disabled beneficiaries who have reasonable potential for engaging in substantial gainful activity and thereby terminating their entitlement to benefits under section 202 or 223 of the Social Security Act if provided with vocational rehabilitation services as participants in the project, and (ii) develop jointly with each disabled beneficiary so identified an individualized, written rehabilitation program. (C) Each written rehabilitation program developed pursuant to subparagraph (B)(ii) for any participant shall include among its provisions— (i) a statement of the participant’s rehabilitation goal, (ii) a statement of the specific rehabilitation services to be provided and of the identity of the provider to furnish such services, (iii) the projected date for the initiation of such services and their anticipated duration, and (iv) objective criteria and an evaluation procedure and schedule for determining whether the stated rehabilitation goal is being achieved. (d) Reports.—The Secretary of Health and Human Services shall submit to the Committee on Ways and Means of the House of Representatives and the Committee on Finance of the Senate an interim written report on the progress of the demonstration projects conducted under this section not later than April 1, 1992, together with any related data and materials which the Secretary considers appropriate. The Secretary shall submit a final written report to such Committees addressing the matters to be determined under subsection (b) not later than April 1, 1994. (e) State.—For purposes of this section, the term “State” means a State, including the entities included in such term by section 210(h) of the Social Security Act (42 U.S.C. 410(h)). (f) Continuation of Demonstration Authority.—Section 505(c) of the Social Security Disability Amendments of 1980 (42 U.S.C. 1310 note) is amended to read as follows: “(c) The Secretary shall submit to the Congress a final report with respect to all experiments and demonstration projects carried out under this section (other than demonstration projects conducted under section 5120 of the Omnibus Budget Reconciliation of 1990) no later than October 1, 1993.”.